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This editorial in the WSJ tells readers not to confuse the spirit of a pro-growth initiative in the CEO statement of Oct. 2012 with a simple tax increase. The CEO's are doing this as a part of a larger effort for a strong recovery in the U.S. economy and not simply to increase taxes. For the first time CEO's are backing tax increases to break the influence of what the Journal calls Republican deadenders who flatly oppose any tax increases period leading to unacceptable deadlock and uncertainty that prevents business from investing and hiring. This is part of a broader set of tax reforms to lower rates overall, reduce tax expenditures and support the Simpson-Bowles commission recommendations framework to reduce the deficit.

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The influence of the AMA convened Relative Value Scale Update Committee (RUC) on how the Medicare payments to doctors is shared, and on the growth of the Medicare budget. Concern that the interested party is driving the decision making process. Medicare costs went up by 9% in 2009. Fears that doctors have too much control over the dollars in the $500 billion Medicare program. The tendency to focus on more expensive procedures and short change preventive and less costly care. Medicare spends $60 billion on doctors fees. The older codes remain in place even when costs are reduced, leading to higher costs for the Medicare budget each year. And there is little incentive for doctors in RUC to revise overvalued codes.

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David Super, a professor at Georgetown University Law School, says letting the fiscal cliff cuts in spending go into effect is fairer to the poor and middle class than the $1.2 trillion in spending cuts proposed by president Obama and the Democrats. He says the pressure of public opinion would lead to some minideals for the Bush tax cuts to go to lower incomes and for restoring some funds to defense after the fiscal cliff agreement goes into effect, leading to a fairer outcome.

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Krauthammer says President Obama has failed to come out openly in support of the Bowles-Simpson commission's recommendations on deficit reduction. The recommendations were made in December 2011. The President's February 2011 budget did not take up these recommendations. He gets a sense that there is too much electioneering in the Obama posture on deficit reduction- being in the best position for the 2012 presidential election rather than a sincere effort. He suggests the Republicans pursue a short term debt ceiling hike of $500 billion containing $500 billion in budget cuts by passing this in the House. And couple this with a call to follow the Simpson-Bowles recommendations which, in one option, cut $1.1 trillion of deductions, credits and loopholes while lowering tax rates across the board to a top rate of 23%. This would give enough time to come up with a thoughtful and open effort with public scrutiny, and is preferable to the current closed door negotiations without the deliberations necessary for decisions of such far reaching consequences. Failing this there is the McConnell Plan B. Boles- Simpson focussed on tax expenditures as a key part of their plan. Martin Feldstein and other experts also point to limiting or eliminating "tax expenditures" (the deductions and loopholes that reduce revenues) as a key part of the solution to the U.S. deficit problem....

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Some ideas from Robert Shiller of Yale University who has widely written about bubbles including the stock bubbles and has jointly developed the Shiller-Case index of housing prices. Shiller suggests creating futures contracts tied to home prices. And the thinking goes once there is enough trqding in these futrues contracts people can sell the housing market short-that is bet on afall in house prices- so that there is a restraining effect on housing bubbles developing. But the reviewer thinks that this is debatable because its possible to sell stocks short and yet we have stock market bubbles. Shillers other suggestion is for developing new types of insurance to protect people from a fall in house prices or from a longterm loss of income as a result of jobs becoming obsolete, but its not clear who would pay for this insurance and its cost. Another suggestion is for the government to to give subsidies or tax credits for ordinary people to get unbiased financial advice. This could be a useful suggestion if there are credible and honest sources of such advice and they are identified and made widely available to the general public by the government. A related suggestion is the development of a supplement to the consumer price index that is based on a realistic basket of goods and services that people use that gives people a realistic idea of what is happening so that they do not assume that houses are always a good long term investment and can separate inflation. And Shiller suggests a standard mortgage contract be developed so that people who cannot understand the fine print like most of us especially when its put in by lawyers for mortgage companies can turn to htis contract. This is an excellent suggestion but one wonders why something so obvious has been not already widely available as an alternative to those who cannot figure out all the machinations behind all that small print. The book is titled SubPrime Solution and one wonders whether much more than this is needed to control all the fog and euphoria about housing prices, and all the incentives and pressure in hard selling tactics of most of the large mortgage companies, and all the ethical violations of credit ratings companies who rated mortgage securities and ethical violations of mortgage companies....

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Allan Blinder gives a spirited account of what he sees in the Paul Ryan Republican deficit reduction plan. He says that with the voucher plan retirees would fall further and further behind the increasing cost of health insurance. With no explicit cost containment proposals it assumes that some kind of miracle will occur for costs to be kept in check- especially as Republicans want to repeal the cost containment proposals in the President's healthcare plan. He asks whether someone is saying, that we have to destroy Medicare so it can be saved. Ryan woulld also turn Medicaid into a block grant, then underfund it and let the states figure it out when they are in a budget squeeze. Blinder points to the estimates of the Center on Budget and Policy Priorities, that show about two-thirds of Ryan's budget cuts would come from programs that serve low and moderate income Americans. And to make matters worse the steep spending cuts go to finance tax cuts that largely benefit the wealthy. He calls this Robin Hood operating in reverse, and coming on top of 30 plus years of rising inequality. David Stockman makes a similiar point on the editorial pages of the New York Times, April 24, 2011; also adding the point that the middle class will have to pay higher taxes for the deficit to be addressed, something President Obama's plan fails to do. Blinder says that the Bowles-Simpson and Rivlin -Domenici proposals attack the deficit reduction problem in a better way, that asks something from all classes and interests. ...

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The Congressional Budget Office's Elmendorf says without spending cuts in payments to doctors and hospitals and other providers, providing coverage to the unisured will put the nation deeper into debt. Popular measures such as increasing preventative care, expanding medical records and rewarding doctors for choosing treatments that improve cost and quality have potential but its not proven how much the savings from this would be. The administration and the White House Budget Director, Peter Orszag, say they are in agreement with the CBO that something needs to be done to seriously reduce costs, reducing payments for Medicare and Medicaid to doctors and hospitals, and making other changes.

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Taylor goes over details of the Romney Plan and why it is better for economic recovery in the U.S.

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Leonhardt argues that rationing is rational allocation of limited resources, health care budgets are limited resources even in rich countries like the USA, and if you overpay here you cut somewhere else. Now the cuts that are not noticed he says are in take home pay as employers face increased premiums from insurers. Rationing is taking place all the time with poor health outcomes relative to the cost for poor allocation of resources as survival rate for many diseases are not that much better than other countries. Rationing takes place everyday when patients see doctors only for a few minutes as doctors race to see more patients, and when diseases are not caught early on in the process as doctors do not know their patients well enough. And rationing is taking place as patients simply delay or forego treatments based on the extra cost, or as uninsured get no care. There are so many buzzwords like this thrown around, with doctors, hospitals and insurers and other groups trying to preserve the status quo, even as it is becoming rapidly unaffordable fort the US to be spending so much on health care....

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Some startling statistics on U.S. wages and incomes and the increase of part-time workers, by the publisher of U.S. News and World Report, Mortimer Zuckerman. He cites the Pew Research Center reports that show one third of Americans identifying themeselves as lower class or lower middle class compared to one quarter before 2008. This affects social mobility with the increasing gaps in incomes, education and social behaviour acting to reinforce each other and leading to even lower future mobility. Industries that are showing growth are in low wage occupations. The Bureau of Labor Statistics shows growth in future in industries noted for low wage part time work- health care, social assistance and retail, with some jobs lacking minimum wage and overtime protections. Revealing in this respect is that in the last 2 years fully 43% of net employment growth is in the 1.7 million jobs added in low wage work in food service, retail and employment services industries. The number of Americans working full time declined by 5.9 million since Sept 2007, part time workers increased by 2.6 million. The effects of higher part time workers and job recovery predominantly in lower wage industries is likely to affect consumer spending and slow growth....

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Feldstein, adviser to the Romney campaign, refutes the assertion based on computer models that the Romney Tax Plan of a 20% across the board cut in taxes cannot be paid for by limiting the deductions of high income tax earners. His own analysis based on IRS data, shows taxpayers with adjusted gross incomes of over $100,000 made itemized deductions of $636 billion in 2009. By taxing these deductions at a 30% marginal rate, additional revenue of $191 billion can be raised to pay for the Romney Tax Plan's static revenue loss of $181 billion. A smaller revenue loss of $148 billion is predicted based on increased incomes and taxes from the behavioural effects of lower taxes on earners. He says this was the thinking behind the Reagan tax cuts of 1986 and the Simpson-Bowles commission plan that would generate economic growth by reforming the tax system's distortions.

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Krugman compares the Republican Ryan Plan and the plan proposed by President Obama for deficit reduction. He also compares the Ryan plan on Medicare and Obama's proposed plan for Medicare.

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Brooks looks at the Obama and Ryan deficit reduction plans and sees something to like in both plans. He agrees with Ryan that modern medical technologies are becoming too costly to afford- especially with aging populations here and in Europe- and the need for consumers of medical care to shoulder some of the burden to control these costs. He agrees also with Ryan on the need for seniors and the middle class to share some of the burden of rebalancing benefit systems. He agrees with Obama in the need for a balanced approach combining tax increases with spending cuts, and the contribution government can make through targeted investments. He is pessimistic about the chances of bringing the two approaches together taking their best points because of the political climate which is increasingly partisan.

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New York state governor Andrew Cuomo says the turnaound in the last 15 months for the state budget shows that things went from "a model of dysfunction to a model of function."